ABSTRACT
The Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease was approved by Sociedade Brasileira de Transplante de Medula Óssea , with the participation of 26 Brazilian hematopoietic stem cell transplantation centers. It describes the main nutritional protocols in cases of Graft- versus -host disease, the main complication of hematopoietic stem cell transplantation.
Subject(s)
Consensus Development Conferences as Topic , Graft vs Host Disease/diet therapy , Graft vs Host Disease/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Nutrition Therapy/standards , Nutritional Requirements , Brazil , Congresses as Topic , Gastrointestinal Diseases/diet therapy , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/physiopathology , Graft vs Host Disease/physiopathology , Humans , Nutrition Therapy/methods , Severity of Illness IndexABSTRACT
ABSTRACT The Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease was approved by Sociedade Brasileira de Transplante de Medula Óssea , with the participation of 26 Brazilian hematopoietic stem cell transplantation centers. It describes the main nutritional protocols in cases of Graft- versus -host disease, the main complication of hematopoietic stem cell transplantation.
RESUMO O Consenso Brasileiro de Nutrição no Transplante de Células Tronco Hematopoiéticas: doença do enxerto contra o hospedeiro foi aprovado pela Sociedade Brasileira de Transplante de Medula Óssea, com a participação de 26 centros brasileiros de transplante de células-tronco hematopoiéticas. O Consenso descreve as principais condutas nutricionais em casos de doença do enxerto contra o hospedeiro, a principal complicação do transplante de células-tronco hematopoiéticas.
Subject(s)
Consensus Development Conferences as Topic , Hematopoietic Stem Cell Transplantation/adverse effects , Nutrition Therapy/standards , Graft vs Host Disease/diet therapy , Graft vs Host Disease/etiology , Nutritional Requirements , Severity of Illness Index , Brazil , Congresses as Topic , Nutrition Therapy/methods , Gastrointestinal Diseases/diet therapy , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/physiopathology , Graft vs Host Disease/physiopathologyABSTRACT
OBJECTIVES: Acute kidney injury is associated with many conditions, and no interventions to improve the outcomes of established acute kidney injury have been developed. We performed this study to determine whether goal-directed therapy conducted during the early stages of acute kidney injury could change the course of the disease. METHODS: This was a multicenter prospective randomized controlled study. Patients with early acute kidney injury in the critical care unit were randomly allocated to a standard care (control) group or a goal-directed therapy group with 8h of intensive treatment to maximize oxygen delivery, and all patients were evaluated during a period of 72h. ClinicalTrials.gov: NCT02414906. RESULTS: A total of 143 patients were eligible for the study, and 99 patients were randomized. Central venous oxygen saturation was significantly increased and the serum lactate level significantly was decreased from baseline levels in the goal-directed therapy group (p=0.001) compared to the control group (p=0.572). No significant differences in the change in serum creatinine level (p=0.96), persistence of acute kidney injury beyond 72h (p=0.064) or the need for renal replacement therapy (p=0.82) were observed between the two groups. In-hospital mortality was significantly lower in the goal-directed therapy group than in the control group (33% vs. 51%; RR: 0.61, 95% CI: 0.37-1.00, p=0.048, number needed to treat=5). CONCLUSIONS: Goal-directed therapy for patients in the early stages of acute kidney injury did not change the disease course.
Subject(s)
Acute Kidney Injury/therapy , Early Goal-Directed Therapy , Acute Kidney Injury/mortality , Aged , Case-Control Studies , Female , Hospital Mortality , Humans , Male , Middle Aged , Patient Care Planning , Prospective Studies , Treatment OutcomeABSTRACT
OBJECTIVES: Acute kidney injury is associated with many conditions, and no interventions to improve the outcomes of established acute kidney injury have been developed. We performed this study to determine whether goal-directed therapy conducted during the early stages of acute kidney injury could change the course of the disease. METHODS: This was a multicenter prospective randomized controlled study. Patients with early acute kidney injury in the critical care unit were randomly allocated to a standard care (control) group or a goal-directed therapy group with 8h of intensive treatment to maximize oxygen delivery, and all patients were evaluated during a period of 72h. ClinicalTrials.gov: NCT02414906. RESULTS: A total of 143 patients were eligible for the study, and 99 patients were randomized. Central venous oxygen saturation was significantly increased and the serum lactate level significantly was decreased from baseline levels in the goal-directed therapy group (p=0.001) compared to the control group (p=0.572). No significant differences in the change in serum creatinine level (p=0.96), persistence of acute kidney injury beyond 72h (p=0.064) or the need for renal replacement therapy (p=0.82) were observed between the two groups. In-hospital mortality was significantly lower in the goal-directed therapy group than in the control group (33% vs. 51%; RR: 0.61, 95% CI: 0.37-1.00, p=0.048, number needed to treat=5). CONCLUSIONS: Goal-directed therapy for patients in the early stages of acute kidney injury did not change the disease course.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Early Goal-Directed Therapy , Patient Care Planning , Case-Control Studies , Prospective Studies , Treatment Outcome , Hospital Mortality , Acute Kidney Injury/mortality , Acute Kidney Injury/therapyABSTRACT
ABSTRACT The herein presented assay provided a bacteriological and molecular characterization of 100 samples of L. monocytogenes isolated from human (43) and food (57) sources, from several regions of Brazil, and collected between 1975 and 2013. Antigenic characterization defined 49% of serotype 4b samples, followed by 28% of serotype 1/2b, 14% of serotype 1/2c, 8% of serotype 1/2a, and 1% of serotype 3b. Both type of samples from human and food origin express the same serotype distribution. Multiplex PCR analysis showed 13 strains of type 4b with the amplification profile 4b-VI (Variant I). Virulence genes hly, inlA, inlB, inlC, inlJ, actA, plcA, and prfA were detected in all samples, highlighting a deletion of 105pb on the actA gene in 23% of serotype 4b samples. Macrorestriction profile with ApaI at PFGE showed 55 pulsotypes, with the occurrence of the same pulsotype in hospitalized patients in São Paulo in 1992 and 1997, and two other highly related pulsotypes in patients hospitalized in Rio de Janeiro in 2008. Recognized pulsotypes in listeriosis cases have also been detected in food. Thus, the prevalence of a serotype and the persistence of certain pulsotypes herald future problems.
Subject(s)
Humans , Virulence Factors/genetics , Food Microbiology , Listeria monocytogenes/genetics , Brazil , Serotyping , Electrophoresis, Gel, Pulsed-Field , Molecular Typing , Multiplex Polymerase Chain Reaction , Genes, Bacterial/genetics , Listeria monocytogenes/isolation & purification , Listeria monocytogenes/pathogenicityABSTRACT
The herein presented assay provided a bacteriological and molecular characterization of 100 samples of L. monocytogenes isolated from human (43) and food (57) sources, from several regions of Brazil, and collected between 1975 and 2013. Antigenic characterization defined 49% of serotype 4b samples, followed by 28% of serotype 1/2b, 14% of serotype 1/2c, 8% of serotype 1/2a, and 1% of serotype 3b. Both type of samples from human and food origin express the same serotype distribution. Multiplex PCR analysis showed 13 strains of type 4b with the amplification profile 4b-VI (Variant I). Virulence genes hly, inlA, inlB, inlC, inlJ, actA, plcA, and prfA were detected in all samples, highlighting a deletion of 105pb on the actA gene in 23% of serotype 4b samples. Macrorestriction profile with ApaI at PFGE showed 55 pulsotypes, with the occurrence of the same pulsotype in hospitalized patients in São Paulo in 1992 and 1997, and two other highly related pulsotypes in patients hospitalized in Rio de Janeiro in 2008. Recognized pulsotypes in listeriosis cases have also been detected in food. Thus, the prevalence of a serotype and the persistence of certain pulsotypes herald future problems.
Subject(s)
Food Microbiology , Listeria monocytogenes/genetics , Virulence Factors/genetics , Brazil , Electrophoresis, Gel, Pulsed-Field , Genes, Bacterial/genetics , Humans , Listeria monocytogenes/isolation & purification , Listeria monocytogenes/pathogenicity , Molecular Typing , Multiplex Polymerase Chain Reaction , SerotypingABSTRACT
In this work, we used the Minimum Inhibitory Concentration (MIC) technique to evaluate the antibacterial potential of the apitoxin produced by Apis mellifera bees against the causative agents of tooth decay. Apitoxin was assayed in natura and in the commercially available form. The antibacterial actions of the main components of this apitoxin, phospholipase A2, and melittin were also assessed, alone and in combination. The following bacteria were tested: Streptococcus salivarius, S. sobrinus, S. mutans, S. mitis, S. sanguinis, Lactobacillus casei, and Enterococcus faecalis. The MIC results obtained for the commercially available apitoxin and for the apitoxin in natura were close and lay between 20 and 40 µg / mL, which indicated good antibacterial activity. Melittin was the most active component in apitoxin; it displayed very promising MIC values, from 4 to 40 µg / mL. Phospholipase A2 presented MIC values higher than 400 µg / mL. Association of mellitin with phospholipase A2 yielded MIC values ranging between 6 and 80 µg / mL. Considering that tooth decay affects people's health, apitoxin and its component melittin have potential application against oral pathogens.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bee Venoms/pharmacology , Enterococcus faecalis/drug effects , Lacticaseibacillus casei/drug effects , Streptococcus/drug effects , Animals , Bee Venoms/chemistry , Bee Venoms/enzymology , Melitten/pharmacology , Microbial Sensitivity Tests , Phospholipases A2/pharmacologyABSTRACT
In this experiment, methods of total fecal collection (TFC) and internal markers (acid-insoluble ash - AIA, crude fiber - CF, and acid-detergent fiber - ADF) were compared for determination of the coefficients of apparent digestibility (CAD) for dry matter (DM), crude protein (CP), ether extract (EE), nitrogen-free extracts (NFE), and gross energy (GE) of commercial feline dry kibble for ocelots (Leopardus pardalis). Six adult animals, weighing 12.45±1.37 kg, gradually received experimental kibble in their usual diet until the beginning of the experiment and were submitted to an adaptation period ten days prior to the collection period. CAD obtained by TFC, AIA, CF, and ADF were, respectively, 73.7, 76.83, 62.01, and 46.03% for dry matter; 81.9, 84.8, 75.8, and 63.8% for crude protein; 85, 86.7, 78.5, and 69.1% for ether extract; 78.52, 79.55, 69.11, and 53.04% for nitrogen-free extracts; and 80.5, 82.2, 71.4, and 58.4% for gross energy. The AIA method showed to be efficient in determining coefficients of apparent digestibility and may contribute to investigations on the digestibility of diets for wild felines. In comparison to the items of ocelot's usual diet, the kibble used in this paper provided an adequate nutritional supply with reduced daily costs per animal.
Neste experimento foram comparados os métodos de coleta total de fezes (CT) e de indicadores internos (cinza insolúvel em ácido - CIA, fibra bruta - FB e fibra em detergente ácido - FDA) na determinação dos coeficientes de digestibilidade aparente (CDA) da matéria seca (MS), proteína bruta (PB), extrato etéreo (EE), extrativo não nitrogenado (ENN) e energia bruta (EB) de uma ração comercial de gatos-domésticos para jaguatiricas (Leopardus pardalis). Seis animais adultos com peso de 12,45 ± 1,37kg receberam gradativamente a ração experimental na dieta habitual até o início do experimento e foram submetidos a um período de adaptação de 10 dias anteriores ao período de coleta. Os CDA obtidos pela CT, CIA, FB e FDA foram, respectivamente de 73,70; 76,83; 62,01 e 46,03% para matéria seca, 81,9; 84,8; 75,8 e 63,8% para proteína bruta, 85,0; 86,7; 78,5 e 69,1% para extrato etéreo, 78,52; 79,55; 69,11 e 53,04% para extrativo não nitrogenado e de 80,5; 82,2; 71,4 e 58,4% para energia bruta. O método de CIA mostrou-se eficiente na determinação dos coeficientes de digestibilidade aparente e pode contribuir com as investigações sobre a digestibilidade em dietas com felídeos selvagens. A ração utilizada permitiu aos animais um adequado aporte nutricional e apresentou menores custos/animal/dia em comparação aos itens que compunham a dieta habitual.
Subject(s)
Animals , Digestive System , Felidae/physiology , Animal Feed/adverse effects , Feces/chemistryABSTRACT
A instilação intravesical do bacilo de Calmette-Guérin (BCG) é o tratamento de escolha para carcinoma de bexiga in situ ou tumores superficiais de bexiga de alto grau não invasivos. Este tratamento geralmente é bem tolerado, mas podem ocorrer complicações graves. Paciente idoso, coronariopata, portador de carcinoma superficial de bexiga de alto grau recidivado foi submetido à instilação intravesical de BCG, evoluindo com choque séptico. Recebeu antibioticoterapia de amplo espectro, tuberculostáticos, corticóide, aminas vasoativas, suporte ventilatório e tratamento hemodialítico, sem melhora. Faleceu nove dias após a instilação intravesical de BCG por insuficiência de múltiplos órgãos.
Intravesical instillation of bacillus Calmette-Guérin (BCG) is the treatment of choice for carcinoma in situ and non-invasive high-grade superficial tumors of the urinary bladder. This treatment is well tolerated overall, but serious complications can occur. An elderly man with coronary disease and recurrent high-grade superficial carcinoma of the bladder underwent intravesical instillation of BCG and developed septic shock. He received wide range antibiotics, tuberculostatic and vasoactive drugs, corticosteroids, mechanical ventilation and renal replacement therapy without improvement. He died nine days after the intravesical instillation of BCG because of multiple organ failure.
ABSTRACT
Intravesical instillation of bacillus Calmette-Guérin (BCG) is the treatment of choice for carcinoma in situ and non-invasive high-grade superficial tumors of the urinary bladder. This treatment is well tolerated overall, but serious complications can occur. An elderly man with coronary disease and recurrent high-grade superficial carcinoma of the bladder underwent intravesical instillation of BCG and developed septic shock. He received wide range antibiotics, tuberculostatic and vasoactive drugs, corticosteroids, mechanical ventilation and renal replacement therapy without improvement. He died nine days after the intravesical instillation of BCG because of multiple organ failure.
ABSTRACT
This work reports the results of analyses of three complete mycoplasma genomes, a pathogenic (7448) and a nonpathogenic (J) strain of the swine pathogen Mycoplasma hyopneumoniae and a strain of the avian pathogen Mycoplasma synoviae; the genome sizes of the three strains were 920,079 bp, 897,405 bp, and 799,476 bp, respectively. These genomes were compared with other sequenced mycoplasma genomes reported in the literature to examine several aspects of mycoplasma evolution. Strain-specific regions, including integrative and conjugal elements, and genome rearrangements and alterations in adhesin sequences were observed in the M. hyopneumoniae strains, and all of these were potentially related to pathogenicity. Genomic comparisons revealed that reduction in genome size implied loss of redundant metabolic pathways, with maintenance of alternative routes in different species. Horizontal gene transfer was consistently observed between M. synoviae and Mycoplasma gallisepticum. Our analyses indicated a likely transfer event of hemagglutinin-coding DNA sequences from M. gallisepticum to M. synoviae.
Subject(s)
Genome, Bacterial , Mycoplasma Infections/microbiology , Mycoplasma hyopneumoniae/genetics , Mycoplasma synoviae/genetics , Pneumonia of Swine, Mycoplasmal/microbiology , Poultry Diseases/microbiology , Animals , Evolution, Molecular , Gene Rearrangement , Gene Transfer, Horizontal , Genomics , Molecular Sequence Data , Phylogeny , Poultry , SwineABSTRACT
A fluid genome is a great advantage to prokaryotes, enabling quick adaptation to various types of ecological niches and to diverse environmental selective pressures. A substantial portion of these sudden changes is mediated by lateral gene transfer (LGT), through genetic recombination mechanisms, such as transformation, conjugation and transduction. The recent sequencing of several organisms has offered a new approach to the study of LGT, using comparison and analysis of nucleotide sequences dispersed throughout the genome of these species. This analysis in Choromobacterium violaceum has revealed four prophage and 12 insertion sequences, suggesting genetic exchange with several other bacterial species, including Salmonella enterica, Ralstonia and Xanthomonas. An Rhs (recombination hot spot) element (containing a vgr-like gene) was also observed, the function of which remains unknown, but it has a sequence related to species of Acinetobacter and Sphingomonas. These results support the role of LGT in the acquisition of new traits by C. violaceum.
Subject(s)
Bacteriophages/genetics , Chromobacterium/virology , DNA Transposable Elements/genetics , Gene Transfer, Horizontal/genetics , Chromobacterium/genetics , Evolution, MolecularABSTRACT
Chromobacterium violaceum is a free-living bacterium commonly found in aquatic habitats of tropical and subtropical regions of the world. This bacterium is able to produce a large variety of products of biotechnological and pharmacological use. Although C. violaceum is considered to be non-pathogenic, some cases of severe infections in humans and other animals have been reported. Genomic data on the type strain ATCC 12472(T) has provided a comprehensive basis for detailed studies of pathogenicity, virulence and drug resistance genes. A large number of open reading frames associated with various mechanisms of drug resistance were found, comprising a remarkable feature of this organism. Amongst these, beta-lactam (penicillin and cephalosporin) and multidrug resistance genes (drug efflux pumps) were the most numerous. In addition, genes associated with bacitracin, bicyclomycin, chloramphenicol, kasugamycin, and methylenomycin were also found. It is postulated that these genes contribute to the ability of C. violaceum to compete with other bacteria in the environment, and also may help to explain the common drug resistance phenotypes observed in infections caused by this bacterium.
Subject(s)
Anti-Bacterial Agents , Chromobacterium/genetics , Drug Resistance, Bacterial/genetics , Open Reading Frames/genetics , Chromobacterium/drug effects , Genome, BacterialABSTRACT
Se almacenó semen de abejas en agua de coco (Cocos nucifera L.) verde con dihidroestreptomicina y en medios de cultivo comerciales, a diferentes temperaturas, utilizando microtubos capilares de 0,1 cm de diámetro y microtubos de centrífuga con 0,2 ml de capacidad. La motilidad de los espermatozoides fue evaluada luego de 1,2,5,10,15,30,50,80 y 120 días. Reinas fueron inseminadas instrumentalmente con semen diluido y se evaluó su comportamiento reproductivo. El almacenamiento en agua de coco resulta en espermatozoides móviles hasta 80 días. Sin embargo, las reinas ovaron normalmente y resultaron obreras normales solamente cuando se utilizo para la inseminación semen almacenado en agua de coco hasta por 15 días. El agua de coco parece ser un diluente natural ideal para el almacenamiento in vitro de semen de abejas por períodos cortos y puede ser un método apropiado para programas de mejoramiento genético de obejas
Subject(s)
Animals , Bees , Cocos , Insemination , Semen , Water , Science , VenezuelaABSTRACT
Neste trabalho tentou-se conhecer alguns aspectos da criatividade e das relações objetais contidas no impulso criador através de um estudo de caso, com dois pintores de óleo sobre tela,com o Psicodiagnóstico de Rorschach, o Teste das Relações Objetivais de H.Phillipson e a Entrevista Diagnóstica Operacionalizada de Simon. Foi pedido a cada um dos sujeitos que realizassem ilustrações coloridas,com os temas: uma, duas, três e grupo de pessoas com suas respectivas histórias, na linha do T.R.O., e foram como ele avaliadas. Os dados obtidos nas técnicas projetivas foram interpretados de acordo com a teoria de Melaine Klein, à luz das duas principais correntes do estudo da arte-sublimação de Freud e reparação de Klein, desenvolvida por Segal.Para o desenvolvimento da aptidão artística já na posição esquizoparanóide foi considerada a proposta de Likiermam como complementar. Concluiu-se que o impulso para a criação associa-se ao desejo de reparação, de elaboração do luto e à necessidade de recuperação de objetos, parciais e idealizados.Para Segal, o impulso para a reparação se destina principalmente ao objeto total. Foi possível também perceber que as manifestações do impulso criador acompanham o desenvolvimento emocional, sendo mais defensivo quando a personalidade encontra-se menos amadurecida e mais narcísica. Os desenhos coloridos e as histórias de um, dois, três personagens e deles em grupo possibilitaram ampliar a compreensão do mundo interno de pintores (AU)
